Sociocultural aspects of mass delivery of praziquantel in schistosomiasis control: the Abeokuta experience.

BACKGROUND: Schistosomiasis is a public health problem in Nigeria. Although there is an ongoing national program for its control, disease control programs in other countries have shown the need to understand the sociocultural aspects of disease transmission, prevention, and treatment in endemic communities before control efforts are undertaken. OBJECTIVE: To describe sociocultural factors that influence the distribution process of praziquantel for the mass treatment of schistosomiasis infection. METHODS: Data for the study were collected through focus group discussions held separately with adult males and females, male and female adolescents (13-19 years), and male and female children (5-12 years). In-depth interviews were similarly held with the drug distributors of praziquantel for mass treatment and with community/opinion leaders of six hyperendemic communities in Ogun State, Southwest Nigeria on mass treatment using praziquantel. These focus group discussions and in-depth interviews were held both before and following the drug distribution. The data were analyzed using the textual analysis program, Textbase Beta. RESULTS: Following a 3-week period of mass treatment in six communities, we observed an increased awareness of rivers/streams as a source of schistosomiasis. In addition, the communities reported overwhelming support for the mass treatment after receiving treatment. The reasons for this acceptance appear to include the perceived efficacy of praziquantel against the disease and its availability free of charge. The drug's distributors adhered to the originally specified systems-based protocol for mass treatment in only two of the six communities. The systems-based protocol adhered to strict distribution through primary health centers and schools. The four other communities used a community-based approach for mass treatment with praziquantel and attained greater coverage of treatment as a result. CONCLUSION: Obtaining community support and involvement before the implementation of mass treatment of schistosomiasis with praziquantel contributes to an effective treatment strategy for this disease. A detailed assessment of a community's health needs, before the initiation of the control efforts against endemic infections, should be undertaken.

An assessment of parent-child communication on sexuality in lagos, Nigeria.

This study is the first phase of a project designed to help parents acquire skills necessary for comfortable and effective communication about adolescents' sexuality. It assessed parent-child communication on sexuality among the in-school adolescents in Lagos, Nigeria. It was observed that a high proportion of the adolescents interviewed receive information on sexuality from friends and the mass media and also communicate more with their friends on sexuality than with their parents.

Post-intervention Survey on the Knowledge, Attitude, Beliefs and Practices of People in Lagos State, Nigeria about HIV/AIDS.

The purpose of this study was to evaluate the impact of a mass-education campaign on knowledge, attitudes and practice of people leaving in Lagos State, Nigeria. A pre- and post-intervention survey was conducted among 6000 respondents from 116 administrative wards randomly selected from all the 20 Local Government Areas (LGA) in Lagos State (300 respondents per LGA) in January 2002 to document the effect of a series of communication interventions on the prevention of HIV/AIDS implemented between May and December 2001 in the state and to describe the changes that may have occurred in the knowledge base, attitude, beliefs and practices. The result showed that the level of knowledge is relatively high as indicated in both the pre- and post-intervention survey, though there was a gain in knowledge in some areas after the intervention. Respondent's practices as they relate to issues that cause the spread of the disease did not change significantly after the intervention. The study demonstrated that mass campaigns using multiple channels can be effective in HIV/AIDS prevention, with the observed positive change and the sustained level of awareness.

Effectiveness of different approaches to mass delivery of praziquantel among school-aged children in rural communities in Nigeria.

Schistosomiasis is hyperendemic in Nigeria. The national policy on schistosomiasis control has adopted praziquantel as the main drug of use in the control strategy aimed at reducing morbidity. However, the best delivery channel for praziquantel in schistosomiasis control in Nigeria is yet to be determined. This study assessed different channels for praziquantel delivery in a mass treatment effort. Three groups, each of two communities, were assigned to one of the following three channels: health facility (HF), school, and community for mass delivery of praziquantel to school-aged children. Distributors were trained on all aspects of praziquantel distribution and sufficient praziquantel tablets were provided for the drug distribution within 3 weeks following which an evaluation of the drug distribution by the different treatment channels was conducted. Overall, the community channel of delivery achieved the best coverage of 72.2% (range: 69-73%) compared to 44.3% (range: 39.5-62%) and 28.5% (range: 26.3-74.5%) for the HF and school channels, respectively. Community channel of praziquantel delivery as shown in this study ensures good coverage of both in and out-of-school children.

Infant feeding practices of urban low income group in Ibadan.

The feeding pattern of 915 children from the low income areas of Ibadan were determined with the aid of a questionnaire administered on their mothers. All the 915 infants were breast-fed for varying periods starting from birth. About 80% of the infants were breast-fed within 48 hours of delivery but most of the mothers in all areas claimed to have discarded the colostrum produced in the first 24 hours postpartum. Infants not breast-fed until a few days postpartum were fed on glucose water or herbal preparations. Culture played no significant role in infant feeding practices.